Treatment of Lumbar Hernias by Endoscopic Nucleoplasty With Radiofrequency

Abstract

Objective: To evaluate the postoperative outcomes of minimally invasive technique for treating lumbar disc herniation in patients undergoing percutaneous endoscopic nucleoplasty with radiofrequency in the center of minimally invasive procedures Veracruz (CEMIVER) of the HRAEV.. Methods: A descriptive, comparative, ambispective and longitudinal study. The clinical records of patients who underwent herniated disc surgery were reviewed from March 2010 to March 2015. Inclusion criteria were individuals of both sexes, aged 18-65 years, with disc herniation diagnosis by MRI, evocative discography (pain) and clinical evaluation. The variables were analyzed by VAS, Oswestry disability index for functional assessment and Macnab criteria for modified retrospective cross clinical classification. Results: 161 patients were included, 81 female and 80 male, aged between 18 and 65 years with severe (83.8%) and moderate (16.2%) disability according to the Oswestry disability index; the total of excellent results was 83.8%, 9.5% were good, 4.8% were median and 1.9% were poor results, according to the Macnab criteria; the average time of surgery was 84 minutes per procedure, and the postoperative average bleeding was 65 ml. Of the total, 87.4% of the patients were on an outpatient basis and 7.6% had a short hospital stay.. Conclusion: It was found that percutaneous endoscopic nucleoplasty with radiofrequency technique is a procedure that offers great benefits for patients with lumbar disc herniation, including performing it under local anesthesia, with clear visualization of the surgical field, minimal pain, little bleeding, shorter operative time, does not cause instability of anatomical structures and has minimal rate of complications.

Influência do Raio de Curvatura e Tensões Residuais em Hastes de Implantes Pediculares na Coluna Vertebral

“…O número de pessoas com doenças crônicas na coluna tem se acentuado no Brasil, chegando a cerca de 18,5% da população adulta segundo a Pesquisa Nacional de Saúde de 2013 [1]. O tratamento conservador para dores crônicas na coluna são relacionados com reprogramação postural ou medicamentos para dor, porém quando estes não são su cientes para que o paciente tenha uma boa qualidade de vida, pode ser recomendado o processo cirúrgico [2]. Em diversos casos a cirurgia na coluna vertebral utiliza implantes metálicos para o tratamento, como as hastes pediculares posteriores.…”

Degree of Satisfaction With the Endoscopic Treatment of Lumbar Disc Herniation

“…3,5,6 Despite the fact that less invasive techniques have a long learning curve, higher cost, and longer surgical time, this treatment is the trend and literature data have shown that this method is safe, and its indication is increasing in as the technique gains acceptance. 3,[6][7][8][9][10] Minimally invasive spinal surgery has gradually evolved, endoscopic equipment being improved and demonstrating progressive success and, currently, two percutaneous decompression techniques are the most used: transforaminal, described in 2004 by Tsou and Yeung, and interlaminar, described by Choi in 2005. 7 The advantages of using minimally invasive techniques are a smaller surgical incision and less aggression of the soft tissues (multifidus muscles, ligaments, and the facet joint capsules).…”